Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy

Abstract To determine the correlations between six serological inflammatory markers, namely the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (...

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Main Authors: Rongjin Deng, Suhui Zhu, Bin Fan, Xiaohu Chen, Hongbin Lv, Yan Dai
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-85164-2
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author Rongjin Deng
Suhui Zhu
Bin Fan
Xiaohu Chen
Hongbin Lv
Yan Dai
author_facet Rongjin Deng
Suhui Zhu
Bin Fan
Xiaohu Chen
Hongbin Lv
Yan Dai
author_sort Rongjin Deng
collection DOAJ
description Abstract To determine the correlations between six serological inflammatory markers, namely the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), and various stages of type 2 diabetic retinopathy (T2DR). Additionally, the diagnostic value of these markers in T2DR was evaluated. Clinical data were collected from a total of 397 patients with type 2 diabetes who visited the ophthalmology department at Mian Yang Central Hospital and the Affiliated Hospital of Southwest Medical University from January 2023 to December 2023. Based on the results of fundus photography, patients were categorized into a non-diabetic retinopathy group (NDR, n = 121), a non-proliferative diabetic retinopathy group (NPDR, n = 77), and a proliferative diabetic retinopathy group (PDR, n = 199). General patient information and systemic inflammatory markers, including the SII, SIRI, AIRI, NLR, PLR, and MLR, were compared among the groups, and their correlations with T2DR were analyzed. The SII values were found to be significantly higher in the PDR group compared to the NPDR group, which in turn were higher than those in the NDR group (P < 0.05). Similarly, the AISI values were significantly elevated in the PDR group compared to both the NPDR and NDR groups (P < 0.05). The SIRI and MLR values were significantly higher in the PDR group than in the NDR group (P < 0.05). Furthermore, the NLR and PLR values were significantly higher in the NPDR and PDR groups compared to the NDR group (P < 0.05). The Mantel‒Haenszel chi-square test revealed a significant linear trend between the SII and PLR and the incidence of PDR (P < 0.001), with the incidence of PDR increasing as the quartile levels of the SII and PLR increased. Multivariate logistic regression analysis indicated that, compared with NDR, a higher SII was found to be an independent risk factor for NPDR (ORSII = 1.002, p = 0.001) and PDR (ORSII = 1.002, P < 0.001). The ROC curve analysis suggested that the combined assessment of the six inflammatory indices had the highest accuracy in the evaluation of DR, with an area under the curve (AUC) of 0.69, a sensitivity of 54%, and a specificity of 75%. The results of this study indicate that the SII is an independent risk factor for T2DR. A close correlation was observed between the SII and PLR and the occurrence and progression of T2DR. The high accuracy of the combined diagnosis of T2DR via various serological inflammatory markers underscores their potential as early biological indicators for the diagnosis of T2DR.
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spelling doaj-art-985eb6046150474dac7ba6c0e9ce4b842025-01-12T12:21:14ZengNature PortfolioScientific Reports2045-23222025-01-011511910.1038/s41598-025-85164-2Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathyRongjin Deng0Suhui Zhu1Bin Fan2Xiaohu Chen3Hongbin Lv4Yan Dai5Southwest Medical UniversitySouthwest Medical UniversitySouthwest Medical UniversityDepartment of Ophthalmology, Mianyang Central HospitalDepartment of Ophthalmology, Affiliated Hospital of Southwest Medical UniversitySouthwest Medical UniversityAbstract To determine the correlations between six serological inflammatory markers, namely the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), and various stages of type 2 diabetic retinopathy (T2DR). Additionally, the diagnostic value of these markers in T2DR was evaluated. Clinical data were collected from a total of 397 patients with type 2 diabetes who visited the ophthalmology department at Mian Yang Central Hospital and the Affiliated Hospital of Southwest Medical University from January 2023 to December 2023. Based on the results of fundus photography, patients were categorized into a non-diabetic retinopathy group (NDR, n = 121), a non-proliferative diabetic retinopathy group (NPDR, n = 77), and a proliferative diabetic retinopathy group (PDR, n = 199). General patient information and systemic inflammatory markers, including the SII, SIRI, AIRI, NLR, PLR, and MLR, were compared among the groups, and their correlations with T2DR were analyzed. The SII values were found to be significantly higher in the PDR group compared to the NPDR group, which in turn were higher than those in the NDR group (P < 0.05). Similarly, the AISI values were significantly elevated in the PDR group compared to both the NPDR and NDR groups (P < 0.05). The SIRI and MLR values were significantly higher in the PDR group than in the NDR group (P < 0.05). Furthermore, the NLR and PLR values were significantly higher in the NPDR and PDR groups compared to the NDR group (P < 0.05). The Mantel‒Haenszel chi-square test revealed a significant linear trend between the SII and PLR and the incidence of PDR (P < 0.001), with the incidence of PDR increasing as the quartile levels of the SII and PLR increased. Multivariate logistic regression analysis indicated that, compared with NDR, a higher SII was found to be an independent risk factor for NPDR (ORSII = 1.002, p = 0.001) and PDR (ORSII = 1.002, P < 0.001). The ROC curve analysis suggested that the combined assessment of the six inflammatory indices had the highest accuracy in the evaluation of DR, with an area under the curve (AUC) of 0.69, a sensitivity of 54%, and a specificity of 75%. The results of this study indicate that the SII is an independent risk factor for T2DR. A close correlation was observed between the SII and PLR and the occurrence and progression of T2DR. The high accuracy of the combined diagnosis of T2DR via various serological inflammatory markers underscores their potential as early biological indicators for the diagnosis of T2DR.https://doi.org/10.1038/s41598-025-85164-2Systemic immune inflammation indexSystemic inflammatory response indexAggregate index of systemic inflammationNeutrophil-to-lymphocyte ratioPlatelet-to-lymphocyte ratioMonocyte-to-lymphocyte ratio
spellingShingle Rongjin Deng
Suhui Zhu
Bin Fan
Xiaohu Chen
Hongbin Lv
Yan Dai
Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy
Scientific Reports
Systemic immune inflammation index
Systemic inflammatory response index
Aggregate index of systemic inflammation
Neutrophil-to-lymphocyte ratio
Platelet-to-lymphocyte ratio
Monocyte-to-lymphocyte ratio
title Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy
title_full Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy
title_fullStr Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy
title_full_unstemmed Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy
title_short Exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy
title_sort exploring the correlations between six serological inflammatory markers and different stages of type 2 diabetic retinopathy
topic Systemic immune inflammation index
Systemic inflammatory response index
Aggregate index of systemic inflammation
Neutrophil-to-lymphocyte ratio
Platelet-to-lymphocyte ratio
Monocyte-to-lymphocyte ratio
url https://doi.org/10.1038/s41598-025-85164-2
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